Efficacy of electroconvulsive therapy for depressive disorders in a Bavarian district hospital

ECT has been shown to be an effective and well-tolerated treatment for a variety of psychiatric disorders. Due to various reasons, eg lacking of an appropriate anesthesiology department, in most german psychiatric district hospitals this methodology is not available. In our department, ECT is well established and we even perform this therapy for patients of other hospitals in the neighbourhood. The present study was performed to evaluate the efficacy and safety of this method in our setting. Therefore, all treatments during the year 2004 were retrospectively examined with respect to psychopathological changes and to specific side effects.

During 2004, in 39 patients 463 single ECT-treatments were performed during 43 treatment cycles (mean 11.6 treatments/cycle). 37 patients suffered from a major depressive episode (30 unipolar depression, 6 bipolar depression, 1 single episode), 2 patients from schizoaffective disorder. Only in 4 patients we discontinued the treatment within the cycle after 1–3 treatments because of severe side effects or because of the patients decision. Including these patients, the treatment was effective in 74% of the patients.

The majority of the patients were treatment resistant to conventional psychopharmacological treatment strategies before. Hence, these findings suggest that ECT should also be used in non-academic hospitals and there is a need for infrastructural changes in psychiatric hospitals to allow them to use this effective methodology.